Mobile bearing knee prosthesis

ABSTRACT

In one embodiment of the present invention a mobile bearing knee prosthesis may include an interface (e.g., a spherical radius interface) comprised of a concave superior surface on a tray and a convex inferior surface on a tibial insert. In another embodiment of the present invention a mobile bearing knee prosthesis may include an interface (e.g., a spherical radius interface) comprised of a convex superior surface on a tibial tray and a concave inferior surface on a insert. In another embodiment of the present invention a mobile bearing knee prosthesis may include a bi-concave interface (e.g., having a “wave” like surface geometry). This “wave” like surface geometry may be at the second bearing (i.e., at the interface between a tibial insert and a tray in the mobile bearing knee as opposed to the interface between the tibial insert and a femoral component).

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.10/894,146, filed Jul. 19, 2004, which claims the benefit of U.S.Provisional Application Ser. No. 60/487,907, filed Jul. 17, 2003 andU.S. Provisional Application Ser. No. 60/551,369, filed Mar. 9, 2004.Each of the aforementioned applications is incorporated herein byreference in its entirely.

FIELD OF THE INVENTION

In one embodiment of the present invention a mobile bearing kneeprosthesis may include an interface (e.g., a spherical radius interface)comprised of a concave superior surface on a tibial tray and a convexinferior surface on a tibial insert.

In another embodiment of the present invention a mobile bearing kneeprosthesis may include an interface (e.g., a spherical radius interface)comprised of a convex superior surface on a tray and a concave inferiorsurface on a tibial insert.

In another embodiment of the present invention a mobile bearing kneeprosthesis may include a bi-concave interface (e.g., having a “wave”like surface geometry). This “wave” like surface geometry may be at thesecond bearing (i.e., at the interface between a tibial insert and atibial tray in the mobile bearing knee as opposed to the interfacebetween the tibial insert and a femoral component). Further, this “wave”like surface geometry may allow a “virtual” axis of rotation to beprovided by the second bearing.

In one example (which example is intended to be illustrative and notrestrictive) the tibial insert may include a polyethylene articulatingsurface. In another example (which example is intended to beillustrative and not restrictive) the tibial tray may include a metalarticulating surface (e.g., a highly polished metal articulatingsurface). In another example (which example is intended to beillustrative and not restrictive) one or both of the articulatingsurfaces may include diamond (e.g., to improve wear characteristics onone or more mating surfaces).

For the purposes of the present application the term “rotationalconstraint” is intended to refer to essentially stopping rotation of anobject at a given point.

Further, for the purposes of the present application the term“rotational control” is intended to refer to exercising control over theamount of force required to rotate an object.

Further still, for the purposes of the present application the term“superior surface” is intended to be synonymous with the term “topsurface”.

Further still, for the purposes of the present application the term“inferior surface” is intended to be synonymous with the term “bottomsurface”.

BACKGROUND OF THE INVENTION

U.S. Pat. No. 6,319,283 relates to a knee component with a mobilebearing. More particularly, this patent relates to an orthopaedic kneecomponent for implanting within a proximal tibia. The orthopaedic kneecomponent includes a tibial tray with a proximal plateau and aprojection extending generally orthogonal to the plateau. The tibialtray also includes a distally extending stem. A bearing is coupled withthe plateau and has an articular bearing surface for engagement with afemoral component. The bearing is rotationally movable between a firstrotational limit and a second rotational limit about an axis extendinggenerally orthogonal to the tibial plateau. The bearing has a backingsurface engaging the plateau which is sized and shaped such that thebacking surface is substantially entirely supported by the plateau atany position during rotational movement between the first rotation limitand the second rotational limit.

U.S. Pat. No. 5,683,468 relates to a mobile bearing total jointreplacement. More particularly, this patent relates to a prostheticcomponent provided for a condylar joint. The prosthetic componentincludes a platform having a bearing surface and a pair of side walls.The side walls include a pair of concave surfaces which face one anotherand define arcs of the same right circular cylinder. The prostheticcomponent also includes a plastic bearing having a bearing surfaceslidably engaged with the bearing surface of the platform. The bearingalso includes thrust surfaces defining arcs of two right circularcylinders having radii less than the radius of the side wall surfaces ofthe platform. The thrust surfaces are spaced from one another to permitonly limited sliding movement of the bearing in medial to lateraldirections, but greater sliding movement in anterior to posteriordirections.

U.S. Pat. No. 5,556,432 relates to an artificial joint. Moreparticularly, this patent relates to an endoprothesis for the human kneejoint, consisting of at least two joint parts moving with respect toeach other, a joint head and a joint base, with toroidal joint surfaces,that have function surfaces with differing circular intersectioncontours in mutually perpendicular planes—a longitudinal plane and atransverse plane—whereby the curve ratios of the function surfaces aredefined in each of the planes as either convex--convex, convex-concave,or concave--concave, and the joint geometry of the function areas toeach other in each of the two planes is determined by a link chain withtwo link axes (dimeric link chain), which proceed through the rotationcenters of the function areas with the radii of the attendantintersection contours, respectively.

U.S. Pat. No. 5,358,530 relates to a mobile bearing knee. Moreparticularly, this patent relates to a prosthetic mobile bearing kneeincluding a femoral implant having condyle sections attached to a femurand a tibial tray implant having a plateau attached to a tibia. Thetibial tray implant has a pair of spaced apart, concavely curved plateaubearing surfaces for cooperation and sliding with convexly curvedsurfaces on a bearing. The tibial tray plateau bearing surfaces areshaped to create a gradually increasing resistance to sliding androtational movement of the tibial bearing. The tibial bearing thatinterfits between the femoral and tibial tray implants is constructed inone or two portions.

U.S. Pat. No, 4,224,696 relates to a prosthetic knee. More particularly,this patent relates to a prosthetic knee having as its component parts afemoral implant, a tibial implant, and a meniscal plate disposed betweenthe implants. Knee flexion and extension is permitted by compoundlycurved condyle surfaces of the femoral implant, which resemblecorresponding surfaces of a natural knee, and correspondingly shapedconvex bearing surfaces in the meniscal plate. All other motions of theprosthetic knee take place at the interface between the meniscal plateand tibial implant. This interface is defined by a continuous, concave,spherically shaped surface in the upwardly facing plateau of the tibialimplant and a corresponding, continuous, convex spherical surface of themeniscal plate. The components are biased into mutual engagement alongthe cooperating concave and convex surfaces by the natural ligamentswhich surround the prosthetic knee. The continuous biased engagement ofthe cooperating convex and concave surfaces of the prosthetic kneeassure its stability.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A shows a perspective view of a mobile bearing knee prosthesisaccording to an embodiment of the present invention;

FIG. 1B shows a top plan view of the mobile bearing knee prosthesis ofFIG. 1A;

FIG. 1C shows a side view of the mobile bearing knee prosthesis of FIG.1A;

FIG. 1D shows another top plan view of the mobile bearing kneeprosthesis of FIG. 1A;

FIG. 1E shows a cross section taken along line A-A of FIG. 1D;

FIG. 2A shows a top plan view of a mobile bearing knee prosthesisaccording to another embodiment of the present invention;

FIG. 2B shows a cross section taken along line H-H of FIG. 2A;

FIG. 2C shows a perspective view of the mobile bearing knee prosthesisof FIG. 2A;

FIG. 3 shows a perspective view of a mobile bearing knee prosthesisaccording to another embodiment of the present invention;

FIG. 4A shows a plan view of a tibial tray component of a mobile bearingknee prosthesis according to another embodiment of the presentinvention;

FIG. 4B shows a side view of the tibial tray component of FIG. 4A;

FIG. 4C shows a plan view of a tibial insert component of a mobilebearing knee prosthesis according to another embodiment of the presentinvention;

FIG. 4D shows a side view of the tibial insert component of FIG. 4C;

FIG. 5A shows a plan view of a tibial tray component of a mobile bearingknee prosthesis according to another embodiment of the presentinvention;

FIG. 5B shows a side view of the tibial tray component of FIG. 5A;

FIG. 6A shows a plan view of a tibial tray component of a mobile bearingknee prosthesis according to another embodiment of the presentinvention;

FIG. 6B shows a side view of the tibial tray component of FIG. 6A;

FIG. 7A shows a plan view of a mobile bearing knee prosthesis accordingto another embodiment of the present invention;

FIG. 7B shows a cross section of the mobile bearing knee prosthesis ofFIG. 7A;

FIG. 7C shows a side view of the tibial tray of the mobile bearing kneeprosthesis of FIG. 7A;

FIG. 8A shows a perspective view of a mobile bearing knee prosthesisaccording to another embodiment of the present invention;

FIG. 8B shows a perspective view (partially cut-away) of the mobilebearing knee prosthesis of FIG. 8A;

FIG. 8C shows a perspective view (partially cut-away) of the mobilebearing knee prosthesis of FIG. 8A;

FIG. 9A shows a top plan view of a mobile bearing knee prosthesisaccording to another embodiment of the present invention (wherein atibial insert is shown rotated and locked in place on a tibial tray);

FIG. 9B shows a cross section of the mobile bearing knee prosthesis ofFIG. 9A;

FIG. 9C shows certain detail associated with the mobile bearing kneeprosthesis of FIG. 9A;

FIG. 9D shows certain detail associated with the mobile bearing kneeprosthesis of FIG. 9A;

FIG. 10A shows a plan view of a tibial tray according to anotherembodiment of the present invention;

FIG. 10B shows a cross section of the tibial tray of FIG. 10A;

FIG. 10C shows a plan view of a tibial insert for use with the tibialtray of FIG. 10A;

FIG. 10D shows a plan view of the tibial tray and tibial insert of FIGS.10A-10C;

FIG. 10E shows certain detail taken along line B-B of FIG. 10D;

FIG. 10F shows certain detail taken along line B-B of FIG. 10D;

FIG. 11 shows a side view of a mobile bearing knee prosthesis accordingto another embodiment of the present invention;

FIG. 12A shows a plan view of a mobile bearing knee prosthesis accordingto another embodiment of the present invention;

FIG. 12B shows a side view of the mobile bearing knee prosthesis of FIG.12A;

FIG. 13A shows an elevation view of a mobile bearing knee according toanother embodiment of the present invention (in this view a tibialinsert and a tibial tray are engaged and a uniform curvature betweenmating parts is seen);

FIG. 13B shows an elevation view of a mobile bearing knee according tothe embodiment of FIG. 13A (in this view a tibial insert and a tibialtray are partially engaged and a uniform curvature between mating partsis seen);

FIG. 13C shows a side elevation view of a mobile bearing knee accordingto the embodiment of FIG. 13A (in this view a tibial insert and a tibialtray are engaged and a uniform curvature between mating parts is seen);

FIG. 13D shows a side elevation view of a mobile bearing knee accordingto the embodiment of FIG. 13A (in this view a tibial insert and a tibialtray are partially engaged and a uniform curvature between mating partsis seen);

FIG. 13E shows another elevation view of a mobile bearing knee accordingto the embodiment of FIG. 13A (in this view a tibial insert and a tibialtray are engaged, the tibial insert is rotated 10° relative to thetibial tray, and a uniform curvature between mating parts is seen);

FIG. 13F shows a perspective view of a mobile bearing knee according tothe embodiment of FIG. 13A (wherein a tibial insert and a tibial trayare engaged, and a uniform curvature between mating parts is seen);

FIG. 14A shows another elevation view of a mobile bearing knee accordingto the embodiment of FIG. 13A (wherein the Fig. includes across-sectional line indicator through the center of the mobile bearingknee);

FIG. 14B shows a cross-section along the cross-sectional line indicatorof FIG. 14A (wherein the relationship of the “wave” geometry to an axialpost on the tibial insert is seen);

FIG. 14C shows another elevation view of a mobile bearing knee accordingto the embodiment of FIG. 13A (wherein the Fig. includes across-sectional line indicator through the center of the mobile bearingknee and the tibial insert is rotated 10° relative to the tibial tray);

FIG. 14D shows a cross-section along the cross-sectional line indicatorof FIG. 14C (wherein the relationship of the “wave” geometry to an axialpost on the tibial insert is seen and the tibial insert is rotated 10°relative to the tibial tray);

FIGS. 15A-15C show perspective views (at various angles) of the inferiorsurface of a tibial insert of a mobile bearing knee prosthesis accordingto an embodiment of the present invention;

FIGS. 16A and 16B show perspective views (at various angles) of thesuperior surface of a tibial tray of a mobile bearing knee prosthesisaccording to an embodiment of the present invention;

FIGS. 17A-17C show schematic cross-sectional views of a mobile bearingknee according to an embodiment of the present invention;

FIGS. 18A and 18B show schematic cross-sectional views of a mobilebearing knee according to an embodiment of the present invention;

FIGS. 19A and 19B show schematic plan views of a centered pivotingfeature (FIG. 19A) and an eccentered (or offset) pivoting feature (FIG.19B) according to embodiments of the present invention; and

FIGS. 20A-20E show schematic plan views of offset pivot mechanismsaccording to embodiments of the present invention.

Among those benefits and improvements that have been disclosed, otherobjects and advantages of this invention will become apparent from thefollowing description taken in conjunction with the accompanyingfigures. The figures constitute a part of this specification and includeillustrative embodiments of the present invention and illustrate variousobjects and features thereof.

DETAILED DESCRIPTION OF THE INVENTION

Detailed embodiments of the present invention are disclosed herein;however, it is to be understood that the disclosed embodiments aremerely illustrative of the invention that may be embodied in variousforms. In addition, each of the examples given in connection with thevarious embodiments of the invention are intended to be illustrative,and not restrictive. Further, the figures are not necessarily to scale,some features may be exaggerated to show details of particularcomponents. Therefore, specific structural and functional detailsdisclosed herein are not to be interpreted as limiting, but merely as arepresentative basis for teaching one skilled in the art to variouslyemploy the present invention.

In one embodiment a mobile bearing knee prosthesis may include aninterface (e.g., a spherical radius interface) comprised of a concavesuperior surface on a tibial tray and a convex inferior surface on atibial insert. In another embodiment a mobile bearing knee prosthesismay include an interface (e.g., a spherical radius interface) comprisedof a convex superior surface on a tibial tray and a concave inferiorsurface on a tibial insert. Of note, such a spherical radius may have aninherent tendency to self-align.

In one example (which example is intended to be illustrative and notrestrictive) the tibial insert may include a polyethylene articulatingsurface. In another example (which example is intended to beillustrative and not restrictive) the tibial tray may include a metalarticulating surface (e.g., a highly polished metal articulatingsurface). In another example (which example is intended to beillustrative and not restrictive) one or both of the articulatingsurfaces may include diamond (e.g., to improve wear characteristics onone or more mating surfaces).

In another embodiment of a mobile bearing knee prosthesis the interfacemay have a pivoting location. In one example (which example is intendedto be illustrative and not restrictive) the pivoting location may bedefined by a female feature (e.g., cylinder, cone or combination) thatmates with a male feature (e.g., a post). The pivoting location may bein the center of the interface or the pivoting location may be offsetfrom the center of the interface in one or more of a medial, lateral,anterior and/or posterior directions.

In another embodiment of a mobile bearing knee prosthesis a lockingfeature may be provided to help prevent lift-off of the tibial insert.In one example (which example is intended to be illustrative and notrestrictive) the locking feature may be provided by a male feature(e.g., a post) working in combination with a female feature (e.g.,cylinder, cone or combination) to help prevent lift-off of anarticulating surface (e.g., a polyethylene articulating surface).

In another embodiment of a mobile bearing knee prosthesisanterior/posterior translation and/or medial/lateral translation may beprovided by utilizing a female feature (e.g., cylinder, cone orcombination) which is enlarged to allow for additional movement in oneor more desired planes.

In another embodiment of a mobile bearing knee prosthesis rotationalconstraint and/or control may be provided by medial and/or lateral railsthat interfere and/or wedge with a tibial insert as the tibial insertrotates to a specific angular displacement (the interference and/orwedging may occur at one or both rails). Further, to aid in containmentof the tibial insert, a groove may be provided in one or both rails anda mating feature may be provided on the tibial insert.

In another embodiment of a mobile bearing knee prosthesis rotationalconstraint and/or control may be provided by using a male feature (e.g.,a post) as a spring (e.g., a torsion spring) such that a constrainingmember (e.g., a cross-pin) can be tibial inserted into a receivingmember (e.g., a V-groove) in the male feature.

In another embodiment of a mobile bearing knee prosthesis rotationalconstraint and/or control may be provided by using an ellipsoid surfaceat the rotational interface.

Referring now to FIGS. 1A-1E, Mobile Bearing Knee Prosthesis 100 mayinclude Tibial Tray 102, Tibial Insert 104 and Femoral Component (notshown) which interfaces with Tibial Insert 104.

In one example (which example is intended to be illustrative and notrestrictive) Mobile Bearing Knee Prosthesis 100 may include an interface(e.g., a spherical radius interface) comprised of a concave superiorsurface on the Tibial Tray 102 and a convex inferior surface on theTibial Insert 104 (of note, such a spherical radius may have an inherenttendency to self-align).

In another example (which example is intended to be illustrative and notrestrictive) the Tibial Insert 104 may include a polyethylenearticulating surface. In another example (which example is intended tobe illustrative and not restrictive) the Tibial Insert 102 may include ametal articulating surface (e.g., a highly polished metal articulatingsurface).

Mobile Bearing Knee Prosthesis 100 may have a pivoting location. In oneexample (which example is intended to be illustrative and notrestrictive) the pivoting location may be defined by Cavity 106 thatmates with Post 108. Post 108 may stabilize Mobile Bearing KneeProsthesis 100 against shear forces (e.g., medial/lateral forces in thetransverse plane) as well as serve as a rotational axis.

Mobile Bearing Knee Prosthesis 100 may include locking feature(s) tohelp prevent lift-off of the Tibial Insert 104. In one example (whichexample is intended to be illustrative and not restrictive) the lockingfeature may be provided by Indentation 110 (disposed within Cavity 106)working in conjunction with Raised Portion 112 (disposed on Post 108)(see, for example, FIG. 1E).

Further, Mobile Bearing Knee Prosthesis 100 may provideanterior/posterior translation and/or medial/lateral translation (e.g.,by utilizing Cavity 106 which is enlarged to allow for additionalmovement in one or more desired planes). In one example (which exampleis intended to be illustrative and not restrictive) A/P translation maybe about 4.5 mm.

Referring now to FIGS. 2A-2C, it is seen that the pivoting location maybe placed where desired. For example (which example is intended to beillustrative and not restrictive) the pivoting location may be in thecenter (denoted by the dashed circle “A”), anterior (denoted by thedashed circle “B”), or posterior (denoted by the dashed circle “C”) ofMobile Bearing Knee Prosthesis 200 (which may include Tibial Tray 202and Tibial Insert 204). Of note, FIGS. 2A-2C show a mobile bearing kneeprosthesis similar to that shown in FIGS. 1A-1E but without theIndentation/Raised Portion lift-off prevention mechanism. Of furthernote, it is believed that moving the pivoting location towards theposterior will tend to minimize moments on Post 208. In one example(which example is intended to be illustrative and not restrictive)rotational limits may be between about 50-53 degrees.

Referring now to FIG. 3, Mobile Bearing Knee Prosthesis 300 may includeTibial Tray 302, Tibial Insert 304 and Femoral Component (not shown)which interfaces with Tibial Insert 304. Mobile Bearing Knee Prosthesis300 may include one or more diamond bearing surfaces 310 on anarticulating surface of Tibial Tray 302, on an articulating surface ofTibial Insert 304, in Cavity 306 and/or on Post 308. In this regard,isolation of the articulating surface of Tibial Insert 304 (e.g., thepolyethylene surface) from the articulating surface of Tibial Tray 302with the highly wear-resistant diamond bearing surface(s) 310 helpsavoid the problem of backside wear typically inherent in conventionalmobile bearing knee prostheses.

Referring now to FIGS. 4A-4D, a mobile bearing knee prosthesis mayinclude Tibial Tray 402, Tibial Insert 404 and Femoral Component (notshown) which interfaces with Tibial Insert 404. The mobile bearing kneeprosthesis may include diamond bearing surface(s) 410 on an articulatingsurface of Tibial Tray 402, on an articulating surface of Tibial Insert404, in Cavity 406 and/or on Post 408. In one example (which example isintended to be illustrative and not restrictive) 3-point contactassociated with the diamond bearing surface(s) 410 may establish aplane. In another example (which example is intended to be illustrativeand not restrictive) one or more of the diamond bearing surface(s) 410(e.g., the diamond bearing surface(s) 410 on Tibial Insert 404) may bespherical or hemi-spherical in shape (e.g., to avoid or attenuate edgeloading). In another example (which example is intended to beillustrative and not restrictive) one or more of the diamond bearingsurface(s) 410 may be press-fit.

In another example a rotary stop mechanism may be provided to helpensure that the diamond bearing surface(s) (e.g., the posterior, medialand lateral diamond bearing surface(s)) remain engaged at all times. Inanother example (which example is intended to be illustrative and notrestrictive) this rotary stop mechanism may be diamond against diamond.In this regard, see FIGS. 5A and 5B, where the most anterior diamondbearing of Tibial Tray 502, for example, is elevated (to cause themedial and lateral diamond bearings on the underside of the TibialInsert (not shown) to abut and constrain rotary motion).

Referring now to FIGS. 6A and 6B, a Tibial Tray 602 for a mobile bearingknee prosthesis may include a large diameter surface, such as aspherical surface (a Tibial Insert (not shown) may have a mating largediameter surface, such as a spherical surface, on a backside thereof).The Tibial Tray 602 may include Plane Surface 602 a (which Plane Surface602 a is essentially flat). In one example (which example is intended tobe illustrative and not restrictive) Plane Surface 602 a may be apolyethylene component (e.g., a molded “puck”). In a further example(which example is intended to be illustrative and not restrictive) theareas designated “A” in FIG. 6A may maintain a high contact area.

Referring now to FIGS. 7A-7C, Mobile Bearing Knee Prosthesis 700 mayinclude Tibial Tray 702, Tibial Insert 704 and Femoral Component (notshown) which interfaces with Tibial Insert 704. In one example (whichexample is intended to be illustrative and not restrictive) Tibial Tray702 may have a concave articulating surface and Tibial Insert 704 mayhave a convex articulating surface. The aforementioned articulatingsurfaces may comprise a large radius sphere (e.g., for backsidearticulation of a rotating/mobile prosthesis).

In another example (which example is intended to be illustrative and notrestrictive) there may be a tighter clearance at the area designated “A”in FIG. 7B then there is at the area designated “B” in FIG. 7B.

Referring now to FIGS. 8A-8C an embodiment adapted to aid in rotationalconstraint and/or control is shown.

More particularly, Mobile Bearing Knee Prosthesis 800 may include TibialTray 802, Tibial Insert 804 and Femoral Component (not shown) whichinterfaces with Tibial Insert 804. Mobile Bearing Knee Prosthesis 800may have a pivoting location defined by Cavity 806 that mates with Post808. Further, Cross-pin 806A may mate with Groove 808 a such that duringrotation of Tibial Insert 804 the Cross-pin 806 a acts as a rotationalstop and Post 808 acts as a spring (i.e., a torsion spring to giveresistance to rotation).

In one example (which example is intended to be illustrative and notrestrictive) the diameter of Cross-pin 806 a and/or the size of Groove808 a may be varied to provide different levels of rotational constraintand/or control.

In another example (which example is intended to be illustrative and notrestrictive) the Cross-pin 806 a may be installed prior to implantationof Tibial Tray 802 (whereby Groove 808 a allows Tibial Insert 804 to beinstalled with Tibial Tray 802 in place in the body (e.g., cemented inplace).

Referring now to FIGS. 9A-9D and 10A-10E various additional embodimentsadapted to aid in rotational constraint and/or control and/or to helpprevent tibial insert lift-off are shown.

More particularly, as seen in FIGS. 9A-9C, when Tibial Insert 904 isrotated it contacts Rotation Limiting Tabs 902 a of Tibial Tray 902 (tothereby wedge Tibial Insert 904 in place and inhibit further rotation).

Further, each Rotation Limiting Tab 902 a may include Undercut 902 b tohelp prevent lift-off when extremes of rotation have been reached (Inthis regard, Tibial Insert 904 may include one or more Lips 904 a forengaging Rotational Limiting Tabs 902 a and/or Undercuts 902 b).

Further still, Tibial Insert 904 may include Post 908 which resides inCavity 910 in Tibial Tray 902, whereby Cavity 910 includes Indentation912 for receiving Raised Portion 914 of Post 908. Indentation 912 andRaised Portion 914 may thus cooperate to help prevent lift-off of TibialInsert 904. In one example (which example is intended to be illustrativeand not restrictive) the running clearance between Post 908 and Cavity910 may be between about 0.005 and 0.010 inches.

Further still, FIGS. 10A and 10B show a distance “A” inside an outerwall section of Tibial Tray 1002; FIG. 10C shows distances B₁, B₂ nd Cassociated with Tibial Insert 1004 (wherein distance B₁ and B₂ aregreater than distance A and distance C is less than distance A); andFIG. 10D shows contact points between Tibial Tray 1002 and Tibial Insert1004 when Tibial Insert 1004 is rotated (in the clockwise direction inthis example).

Further still, FIG. 10E shows detail of the interference between TibialTray 1002 and Tibial Insert 1004 at a contact point of FIG. 10D and FIG.10F shows that there is no interference at the contact point of FIG. 10E when the Tibial Insert 1004 is not rotated past a certain point (e.g.,at a “neutral position”). Of note, FIGS. 10E and 10F also show Recess1002 a, which may be used for example for poly flow and/or to aid inpreventing lift-off.

Referring now to FIG. 11, it is seen that Mobile Bearing Knee 1100according to an embodiment of the present invention may include TibialTray 1102 and Tibial Insert 1104, wherein the rotational axis A ofMobile Bearing Knee 1100 may be placed in-line with the natural axis A′of the knee.

Referring now to FIGS. 12A and 12B it is seen that Mobile Bearing Knee1200 according to an embodiment of the present invention may includeTibial Tray 1202 and Tibial Insert 1204. Of note, the design of theseFIGS. 12A and 12B allows retention of the posterior cruciate ligament(PCL) via clearance for the PCL (which does not require posteriorstabilization offered with the PS spine (e.g., as may be required oncertain other embodiments)).

In another embodiment the tibial insert may be made of Ultra HighMolecular Weight Polyethylene (“UHMWPE”). In one example (which exampleis intended to be illustrative and not restrictive) the UHMWPE may bemolded UHMWPE (which, it is believed, wears at a lower rate thanmachined UHMWPE).

Referring now to FIGS. 13A-13F, 14A-14D, 15A-15C, 16A, 16B and 17A-17C,it is noted that under these embodiments of the present invention amobile bearing knee prosthesis may include a bi-concave interface.

In this regard, it is noted that such a bi-concave interface may aid inproviding an optimal anatomic configuration of the knee while at thesame time providing a sufficiently thick (e.g., in terms of wearresistance) tibial insert articulation structure (e.g., polyethylenearticulation structure). In one example (which example is intended to beillustrative and not restrictive), such articulation structure may beabout 6.5 mm thick.

Further, referring in particular to FIG. 17A, it is seen that the tibialinsert articulation structure may have a homogeneous, or constant,thickness (i.e., thickness “X” in this FIG. 17A) and referring inparticular to FIG. 17B, it is seen that the tibial insert articulationstructure may have a non-homogeneous, or non-constant thickness (e.g.,thicker by “Y” at the area marked “A” and “B” in this FIG. 17B).

Further still, such a bi-concave interface may aid in coping with thepotential shear stress provided by lift-off during movement by thepatient (see FIG. 17C, showing an aspect of the invention directed toself-centering against lift-off and reduction or elimination of shearstress to the pivot feature (e.g., axial post)).

Of still further note, the embodiments of these FIGS. 13A-13F, 14A-14D,15A-15C, 16A, 16B and 17A-17C may, of course, include some or all of thevarious pivoting, translating, locking, rotational constraint and/orcontrol features described above.

Referring now to FIGS. 18A and 18B, a mobile bearing knee prosthesisaccording to an embodiment of the present invention may include aninterface (e.g., a spherical radius interface) comprised of a convexsuperior surface on the tibial tray and a concave inferior surface onthe tibial insert (of note, such a spherical radius may have an inherenttendency to self-align).

Of note, the aforementioned configuration may help reduce wear at theinterface between the tibial insert and the tibial tray by ejectingabrasive material (e.g., polyethylene particles created by relativemovement at the interface) out from the interface (see FIG. 18A).

Of further note, as seen in FIG. 18B, the thickness of the materialforming the tibial insert may vary as required (e.g., for optimum wearresistance vs. ease of movement). In one example (which example isintended to be illustrative and not restrictive), the areas marked “A”and “B” may be thicker than the area marked “C”.

Of still further note, the embodiments of these FIGS. 18A and 18B may,of course, include some or all of the various pivoting, translating,locking, rotational constraint and/or control features described above.

Referring now to FIGS. 19A and 19B, it is again noted that a mobilebearing knee prosthesis according to the present invention mayincorporate an eccentered (or offset) pivoting feature (e.g., axialpost). More particularly, in one embodiment such an eccentered pivotingfeature may serve (e.g., during movement by the patient) to decrease theanterior translation associated with the medial condolyte and increasethe roll back (posterior translation) associated with the lateralcondolyte. In this regard, see, for example, FIGS. 19A and 19B, whereFIG. 19A shows the large anterior translation associated with a centralpivot (e.g., at 70° of external rotation of the femur in relation to thetibia) and where FIG. 19B shows the smaller anterior translationassociated with a medially offset pivot (e.g., at 70° of externalrotation of the femur in relation to the tibia). More particularly,these FIGS. 19A and 19B show that the offset pivot results in arelatively smaller anterior translation associated with the medialcondolyte and a relatively larger posterior translation associated withthe lateral condolyte.

Further, it is noted that the embodiments of these FIGS. 19A and 19Bmay, of course, include some or all of the various pivoting,translating, locking, rotational constraint and/or control featuresdescribed above.

Finally, referring now to FIGS. 20A-20E, it is noted that certainembodiments of the present invention relate to use of an offset pivotcomponent (e.g., using an offset axial post) in association with othercomponents which may otherwise be configured for use with a non-offsetpivot component.

For example (which example is intended to be illustrative and notrestrictive), an asymmetric component (e.g., offset axial post) may beutilized in association with a symmetric tibial tray and symmetricbearing (e.g., polyethylene bearing) to operate on a “cam” concept. FIG.20A shows a plan view of a polyethylene bearing (under a no rotationcondition) according to this embodiment and FIG. 20B shows a plan viewof a tibial tray (under a no rotation condition) according to thisembodiment. Further, FIG. 20C shows the eccentric center of rotation (atpoint A) associated with external rotation (right knee) and FIG. 20Dshows the eccentric center of rotation (at point B) associated withexternal rotation (left knee).

Further, FIG. 20E shows a plan view utilizing a “Beam” shape.

Further still, it is noted that the embodiments of these FIGS. 20A-20Emay include one or more internal stop mechanisms (e.g., for rotationalconstraint and/or control). Moreover, the embodiments of these FIGS.20A-20E may be used in connection with a tibial insert and/or a tibialtray having an interface surface which includes flat, concave and/orconvex portions.

Further still, it is noted that the embodiments of these FIGS. 20A-20Emay, of course, include some or all of the various pivoting,translating, locking, rotational constraint and/or control featuresdescribed above.

Of note, for the same size of knee prosthesis (e.g., size 3), thecontact area between the insert and the tibial tray may be higher for a“wave” design than for a flat design (e.g., ten percent higher contactarea). Under certain circumstances, it may be desired to minimize thiscontact area.

Thus, in one embodiment, this contact area between the tibial insert andthe tibial tray may be minimized by reducing the congruence factor ofthe second bearing (i.e., the interface between the tibial insert andthe tibial tray in the mobile bearing knee as opposed to the interfacebetween the tibial insert and the femoral component). It is noted thatthis solution is not possible for a flat design, for which thecongruence factor is always equal to one. It is further noted that anadvantage of the congruence factor approach is when contact only occurson the loaded area.

In another embodiment, wear due to contact between the post and the holemay be decreased because shear stress is absorbed by the tibial tray(e.g., by the medial part of the “wave”).

While a number of embodiments of the present invention have beendescribed, it is understood that these embodiments are illustrativeonly, and not restrictive, and that many modifications may becomeapparent to those of ordinary skill in the art. For example, one or moreappropriate fasteners may be used to assemble the mobile bearing kneeprosthesis of the present invention (e.g., a screw or bolt to hold thetibial insert in correct orientation relative to the tibial tray).Further, the mobile bearing knee prosthesis of the present invention mayprovide a bearing which predicts position, self-aligns, and/orself-centers. Further still, the metal may be polished using any desiredtechnique (e.g., a drill with polishing compound). Further still, thetibial insert may be smaller than the tibial tray (at least in certaindimensions) to prevent overhang during rotation (this may beaccomplished, for example, by reducing the size of the medial/lateralaspect of the tibial insert). Further still, one or more of the matingarticulating surfaces may be formed of poly, metal, diamond, ceramic,polyether ether ketone (“PEEK”) and/or any other desired low frictionarticular materials. Further still, the tibial tray, the tibial insertand/or the femoral component may utilize, for example, a molded-on-metalconfiguration (e.g., UHMWP molded-on-metal). Further still, the tibialtray, the tibial insert and/or the femoral component may comprise, forexample, cobalt chrome and/or titanium. Further still, the femoralcomponent may interface with (e.g., be attached to) the femur of thepatient using any desired mechanism (e.g., cement, one or more undercutsand matching protrusions, mechanical fasteners (e.g., screws), etc.).Further still, the tibial tray may interface with (e.g., be attached to)the tibia of the patient using any desired mechanism (e.g., cement, oneor more undercuts and matching protrusions, mechanical fasteners (e.g.,screws), etc.). Further still, one or more parts of the mobile bearingknee prosthesis according to the present invention may be used to“retrofit” existing prosthesis/components. Further still, the term“mobile bearing knee prosthesis” is, of course, intended to include (butnot be limited to) “rotating platform” type mechanisms and “mensicalbearing” type mechanisms.

1. A mobile bearing knee prosthesis, comprising: a tibial tray forinterfacing with a tibia of a patient; and a tibial insert disposedadjacent the tibial tray; wherein the tibial insert is capable ofmovement relative to the tibial tray and the movement of the tibialinsert relative to the tibial tray includes at least pivotal movement;wherein the pivotal movement is around an axis of rotation defined by apost extending from a bottom surface of the tibial insert into a holeprovided on an upper surface of the tibial tray; wherein the holeprovided on the upper surface of the tibial tray is provided at asubstantially circular raised location; wherein the substantiallycircular raised location curves downward away from the hole along both amedial-lateral axis of the tibial tray and an anterior-posterior axis ofthe tibial tray; wherein at least a portion of a medial edge of thetibial tray and at least a portion of a lateral edge of the tibial traycurve upward as the medial edge and the lateral edge are approached; andwherein the bottom surface of the tibial insert is configured to besubstantially complementary to the top surface of the tibial tray whenthe tibial insert and the tibial tray are aligned in both themedial-lateral axis and the anterior-posterior axis.
 2. The mobilebearing knee prosthesis of claim 1, wherein an upper surface of thetibial insert is configured to receive a femoral component whichinterfaces with a femur of the patient.
 3. The mobile bearing kneeprosthesis of claim 1, further comprising a mechanism for providing atleast one of rotational control and rotational constraint to movement ofthe tibial insert relative to the tibial tray.
 4. The mobile bearingknee prosthesis of claim 3, wherein the mechanism for providing at leastone of rotational control and rotational constraint to movement of thetibial insert relative to the tibial tray comprises a cross-pin disposedwithin the hole and a groove disposed on the post, wherein the cross-pinis received within the groove.
 5. The mobile bearing knee prosthesis ofclaim 3, wherein the mechanism for providing at least one of rotationalcontrol and rotational constraint to movement of the tibial insertrelative to the tibial tray comprises at least a first tab disposedalong the medial edge of the tibial tray and at least a second tabdisposed along the lateral edge of the tibial tray, wherein the firsttab contacts the tibial insert to provide at least one of the rotationalcontrol and the rotational constraint during rotation in a firstdirection and the second tab contacts the tibial insert to provide atleast one of the rotational control and the rotational constraint duringrotation in a second direction.
 6. The mobile bearing knee prosthesis ofclaim 5, wherein the first tab includes a first undercut for receiving afirst edge of the tibial insert and the second tab includes a secondundercut for receiving a second edge of the tibial insert.
 7. The mobilebearing knee prosthesis of claim 1, further comprising a mechanism forsubstantially preventing lift-off of the tibial insert from the tibialtray.
 8. The mobile bearing knee prosthesis of claim 7, wherein themechanism for substantially preventing lift-off of the tibial insertfrom the tibial tray comprises a raised portion on the post cooperatingwith an indentation in a portion of the tibial tray defining the holetherein.
 9. The mobile bearing knee prosthesis of claim 7, wherein themechanism for substantially preventing lift-off of the tibial insertfrom the tibial tray comprises at least a first tab disposed along themedial edge of the tibial tray and at least a second tab disposed alongthe lateral edge of the tibial tray, wherein the first tab includes afirst undercut for receiving a first edge of the tibial insert and thesecond tab includes a second undercut for receiving a second edge of thetibial insert.
 10. The mobile bearing knee prosthesis of claim 1,wherein at least one of the hole and the post is substantially circular.11. The mobile bearing knee prosthesis of claim 1, wherein the hole andthe raised location are disposed at a substantially central locationalong the medial-lateral axis of the tibial tray.
 12. The mobile bearingknee prosthesis of claim 1, wherein the hole and the raised location aredisposed at a substantially central location along theanterior-posterior axis of the tibial tray.
 13. The mobile bearing kneeprosthesis of claim 1, wherein the upper surface of the tibial traycomprises metal and the lower surface of the tibial insert comprisespolyethelene.
 14. The mobile bearing knee prosthesis of claim 13,wherein the tibial tray is formed of metal and the tibial insert isformed of polyethelene.
 15. A mobile bearing knee prosthesis,comprising: a tibial tray for interfacing with a tibia of a patient; anda tibial insert disposed adjacent the tibial tray; wherein the tibialinsert is capable of movement relative to the tibial tray and themovement of the tibial insert relative to the tibial tray includes atleast pivotal movement; wherein the pivotal movement is around an axisof rotation defined by a first cooperating element associated with abottom surface of the tibial insert and a second cooperating elementassociated with an upper surface of the tibial tray; wherein the secondcooperating element is provided at a substantially circular raisedlocation on the upper surface of the tibial tray; wherein thesubstantially circular raised location curves downward away from thesecond cooperating element along both a medial-lateral axis of thetibial tray and an anterior-posterior axis of the tibial tray; whereinat least a portion of a medial edge of the tibial tray and at least aportion of a lateral edge of the tibial tray curve upward as the medialedge and the lateral edge are approached; and wherein the bottom surfaceof the tibial insert is configured to be substantially complementary tothe top surface of the tibial tray when the tibial insert and the tibialtray are aligned in both the medial-lateral axis and theanterior-posterior axis.
 16. The mobile bearing knee prosthesis of claim15, wherein an upper surface of the tibial insert is configured toreceive a femoral component which interfaces with a femur of thepatient.
 17. A mobile bearing knee prosthesis, comprising: a tibial trayfor interfacing with a tibia of a patient; and a tibial insert disposedadjacent the tibial tray; wherein the tibial insert is capable ofmovement relative to the tibial tray and the movement of the tibialinsert relative to the tibial tray includes at least pivotal movement;wherein the pivotal movement is around an axis of rotation provided by afirst cooperating element associated with a bottom surface of the tibialinsert and a second cooperating element associated with a top surface ofthe tibial tray; wherein the tibial tray includes at least a firstdiamond bearing surface; wherein the tibial insert includes at least asecond diamond bearing surface; and wherein at least a portion of thefirst diamond bearing surface and at least a portion of the seconddiamond bearing surface bear against one another.
 18. The mobile bearingknee prosthesis of claim 17, wherein an upper surface of the tibialinsert is configured to receive a femoral component which interfaceswith a femur of the patient.
 19. The mobile bearing knee prosthesis ofclaim 17, wherein the first diamond bearing surface includes a pluralityof diamonds.
 20. The mobile bearing knee prosthesis of claim 17, whereinthe second diamond bearing surface includes a plurality of diamonds. 21.The mobile bearing knee prosthesis of claim 17, wherein the firstdiamond bearing surface includes a plurality of diamonds and the seconddiamond bearing surface includes a plurality of diamonds.
 22. The mobilebearing knee prosthesis of claim 21, wherein at least one of thediamonds of the first diamond bearing surface extends beyond the otherdiamonds of the first diamond bearing surface such that the raiseddiamond cooperates with at least a portion of the second diamond bearingsurface to provide rotational constraint to movement of the tibialinsert relative to the tibial tray.
 23. The mobile bearing kneeprosthesis of claim 21, wherein at least one of the diamonds of thesecond diamond bearing surface extends beyond the other diamonds of thesecond diamond bearing surface such that the raised diamond cooperateswith at least a portion of the first diamond bearing surface to providerotational constraint to movement of the tibial insert relative to thetibial tray.